BillCam

HB 1604-FN - AS INTRODUCED

2022 SESSION

22-2142

05/10

HOUSE BILL 1604-FN

AN ACT including state medical facilities in the statute providing medical freedom in immunizations.

SPONSORS: Rep. Cushman, Hills. 2; Rep. Blasek, Hills. 21; Rep. Roy, Rock. 32; Rep. Pauer, Hills. 26; Rep. Torosian, Rock. 14

COMMITTEE: Health, Human Services and Elderly Affairs

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ANALYSIS

This bill repeals the exemption of county nursing homes, the state hospital, and any other medical facility or provider operated by the state or a political subdivision from the statute pertaining to medical freedom in immunizations.

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Explanation: Matter added to current law appears in bold italics.

Matter removed from current law appears [in brackets and struckthrough.]

Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

22-2142

05/10

STATE OF NEW HAMPSHIRE

In the Year of Our Lord Two Thousand Twenty Two

AN ACT including state medical facilities in the statute providing medical freedom in immunizations.

Be it Enacted by the Senate and House of Representatives in General Court convened:

1 Repeal. RSA 141-C:1-a, II(e), exempting county nursing homes, the New Hampshire state hospital, and any other medical facility or provider operated by the state or a political subdivision from the statute providing medical freedom in immunizations, is repealed.

2 Effective Date. This act shall take effect 60 days after its passage.

LBA

22-2142

12/16/21

HB 1604-FN- FISCAL NOTE

AS INTRODUCED

AN ACT including state medical facilities in the statute providing medical freedom in immunizations.

FISCAL IMPACT: [ X ] State [ X ] County [ ] Local [ ] None

Estimated Increase / (Decrease)

STATE:

FY 2022

FY 2023

FY 2024

FY 2025

Appropriation

Revenue

Indeterminable decrease in federal funds.

Expenditures

Indeterminable impact on state general funds.

Funding Source:

[ X ] General [ ] Education [ ] Highway [ X ] Other - Federal Medicaid Funds

COUNTY:

Revenue

Indeterminable decrease in federal funds.

Expenditures

Indeterminable

METHODOLOGY:

This bill repeals the exemption for county nursing homes, the NH Hospital, and any other medical facility or provider operated by the state or its political subdivisions from the statute providing medical freedom in immunizations. The Department of Health and Human Services anticipates that the bill will result in the federal Centers for Medicare and Medicaid Services (CMS) withholding Medicare and Medicaid payments from the state due to noncompliance with the federal COVID-19 vaccine mandate for health care facilities. The timing and extent of the fiscal impact will depend on when and to what extent CMS implements a policy of withholding payments for noncompliant facilities. The Department notes that in FY21, NH Hospital and Glencliff Home received $38.4 million and $7.1 million in federal payments, respectively. In addition, although the PATH Center (a 16-bed transitional housing facility) was not fully operational during FY21, the program is expected to earn over $500,000 in Medicaid revenue in FY22. The total amount that may be lost is therefore estimated at $46 million per year.

In addition to state-operated facilities, the bill would apply to county nursing homes, which in FY22 and FY23 were budgeted to receive federal funds in the amounts of $111 million and $113.7 million, respectively. The New Hampshire Association of Counties assumes that all such federal funds would be withheld due to noncompliance with the federal mandate.

In the event of lost federal funds, the state facilities identified above would either face budget reductions or require an increase in state general funds to make up the shortfall. The impact on state expenditures is therefore indeterminable. In the case of county nursing homes, any shortfall in FY24 and beyond could be made up for with either county funds or state general funds, depending on decisions made by future legislatures. It is assumed that in FY23, any shortfall would be funded by the state, as county payments for long-term care services in FY23 are statutorily limited by RSA 167:18-a.

It is assumed that the fiscal impact will begin in FY23.

AGENCIES CONTACTED:

Department of Health and Human Services and New Hampshire Association of Counties